There are several options for men in terms of birth control, but only one is considered permanent. If you have had children and no longer want to be able to conceive a child, or have made a decision to not have any children, than a vasectomy is the method of choice. Sperm travel through a tube called a vas deference which connects the testes to the urethra. It is this tubing which is cut and blocked at the time of vasectomy.
The vasectomy is an outpatient procedure done in the office. It is commonly done with mild sedative taken orally and an injection of local anesthetic. During the procedure, the vas deference is isolated and divided, and a section is sent to pathology for review. The two ends are clipped or tied depending on the preference of the urologist. The isolation of the tube can be performed with either two separate incisions or through a single midline incision. The whole procedure usually takes 15-30min and you will go home that day.
At the end of the procedure you are not considered sterile. There is often residual semen/sperm in the portion of the tube that leads to the urethra. We always ask that other forms of protection be utilized until a semen analysis can be performed. The semen analysis is typically done 4 weeks after the procedure, confirming the absence of sperm in the sample. After the procedure, you will still have ejaculations as most of that fluid is not sperm, but secretions from the prostate and seminal vesicles.
During The Procedure:
The procedure is done under sterile technique in our procedure room. You will be given a gentle sedative to take the morning of the procedure and an antibiotic. In preparation for the procedure you should shave your scrotal hair with a clipper or razor if you’re comfortable with that. If not, the nurse will shave. To begin, the surgeon will clean the area with betadine (or cholorhexadine if there is an iodine allergy) and then place a drape to protect the area from contamination. The initial injection of local anesthetic is the most uncomfortable part for most patients and after that is complete, the sensation of pulling should be all that is felt. When the procedure is completed an absorbable suture (stitch) will be placed, and you will put on a scrotal support that should compress your scrotum.
After The Procedure:
Anticipate staying off your feet for the next 48 hours and taking care of yourself. You will be given oral pain medicine to take as needed. You should not carry anything for 48 hours. You will apply an ice pack to your scrotum for 20min at a time at least every 3 hours. The scrotal support should remain in place for 2 days. After 2 days, the dressing can be changed and you can shower. You should keep the scrotum supported for a minimum of 7 days.